Senile dementia of the Alzheimer's type (SDAT) is widely recognized as a problem of increasing proportions in North America as well as around the world. The disease is associated with progressive physical and mental impairment to the point where the patient requires total care, and becomes a tremendous social and economic burden. Progress of the disease is believed to be related to degeneration of certain nerve tracts in the central nervous system, resulting in the loss of associated functions. Pathological studies indicate that brains of SDAT patients have loss of several neurotransmitter systems, related to different functions, but the system which is implicated the most is the cholinergic system. Studies show that several important cholinergic tracts innervating the cortical and hippocampal regions degenerate. Although this particular degeneration may not account for all of the symptoms of SDAT, it may account for the cognitive and memory deficits, which are some of the most difficult symptoms for patients and their families to deal with.
The pharmacological approaches which have been proposed for the managements of SDAT symptoms may be classified in two ways. The first is drugs which improve the function of existing neurons, especially to increase cholinergic nerve function. The second is drugs which decrease degeneration/increase regeneration of nerves.
Two types of drugs have been used in clinical trials to improve central cholinergic functions. The first is compounds which increase the availability of the existing endogenous neurotransmitter, acetylcholine (ACh); and the second is compounds which are exogenous, and mimic the effects of the endogenous transmitter at the receptor. However, these compounds exhibit side effects which limit their use.
It is generally believed that compounds which will increase the availability of the endogenous neurotransmitter are more desirable. Substances in this category are cholinesterase inhibitors, such as physostigmine and pyridostigmine, which decrease the breakdown of ACh, thus prolonging its functional lifetime at the crucial location, the synaptic cleft, and choline and lecithin, which increase the availability of the precursor for synthesis. Thus far other compounds have not been described which directly increase the availability of the endogenous neurotransmitter ACh by any other mechanisms, except by blockade of inhibitory presynaptic receptors (with e.g. atropine or clonidine), or by non-specific depolarization of nerves (e.g. veratridine).
Ginseng is the name given to the dried roots of the ginseng plants (genus Panax) and, more particularly, to extracts of those roots. The roots and their extracts contain a variety of substances including saponins and sapogenins.
Ginseng has been extensively used, mostly in Asia, as a tonic to promote health and well being, and as a medicine in the treatment of various disease conditions. The beneficial attributes of ginseng are attributed to its saponin content, a mixture of glucosides referred to collectively as ginsenosides.